[Pressure] Changing from constant pressure to Auto

[lngtrm1]

I am a long time CPAP user -Airsense 10 Autoset. I have changed doctors twice from moves but don't generally go to them regularly. I have been losing weight over the last 16 months and am down 40 lbs. During that time the doc lowered my constant pressure from 10 to 8, and I lowered myself to 7 mid 2019. My AHI is usually below one.

However, reading recently about Auto PAP I wondered if I should get one (makes sense to me) when I realized I already had one!  So yesterday I set it to Auto and slept the first night. This morning I had ringing in my ear and I feel groggy yet my numbers look good, maybe even better than usual. .36 AHI but hypopnea is .24 which as a % is higher tan normal but nothing too weird. The max pressure was below 8
So a couple questions - What is EPR? And is that something I need to turn on?
When I woke up, the ringing in my ear was accompanied by my feeling like I was shallow breathing or just not getting a lot of air. Is that just because I am used to more pressure?

Thanks for any help.

[Osiris357]

Welcome to the forum. What did you set the pressure range to? Minimum and maximum pressures. If you download OSCAR (click the word OSCAR) and post screenshots of your results the experts in this forum might be able to answer your questions.

[lngtrm1]

Thanks, I left them at the default 4-20 min max. I have the oscar SW, will post last night and the night before.

[Osiris357]

Ok sound good. I’ll let the experts advise you on pressure settings but I will say 4-20 isn’t therapeutic. They will be around to help you shortly after you get the screenshots up. Please arrange them in this order.

Events
Flow rate
Pressure
Leak rate
Flow limitations 
Snore

Best of luck!

[lngtrm1]

Here are the last two nights, before and after setting to auto.        

---

Actualy in reverse order, last night then night before.
Thanks, organized as you stated and posted. 4-20 is the default range for the "Auto" setting.

[Osiris357]

Can I ask why you want to go to to auto mode? You seem perfect fixed at 7.

[Gideon]

Most of the time your pressure is under the 7 that you are used to. Many adults find the pressure of 4 to be too low.

EPR, especially for you, is a comfort feature.  It reduces your pressure on exhale by the value of the setting but never below 4.

I suggest setting the min pressure to 6 and EPR to FullTime and = 2.  Try that a night, if you still feel air starved bump the min up to 7.

[lngtrm1]

Can I ask why you want to go to to auto mode? You seem perfect fixed at 7.

Thats a good question, multiple reasons really. I seem to have times when I really have trouble breathing through my nose, which requires me to sleep on my side to get one side open. Higher pressure at those times would seem to help....at least in theory.

My apnea was moderate and almost all when on my back but I can't sleep all night on my side. So it made sense to have the machine adjust as I move around. Lastly, I feel like I have some cognitive decline and my sleep has been pretty restless lately and I wanted to make sure I was optimizing my PAP before pursuing more expensive options for scans etc.

In general I've never really had refreshing sleep but the data says I have the OSA whipped.

EDIT: Also, maybe most importantly - when I went to the Dr. I reported that I was having more times when the air was being pushed into my mouth, bypassing my normal closure of that path. We reduced it to 8 from 10 and that fixed it. Then I lost more weight it started to recur so I dropped it to 7 and that seemed to solve it. Also, i have had two trips to the ENT for inner ear infections/pain likely caused by the CPAP pressure packing in mucous in my eustachian tube. Basically - I must not drain well.

[lngtrm1]

Most of the time your pressure is under the 7 that you are used to. Many adults find the pressure of 4 to be too low.

EPR, especially for you, is a comfort feature.  It reduces your pressure on exhale by the value of the setting but never below 4.

I suggest setting the min pressure to 6 and EPR to FullTime and = 2.  Try that a night, if you still feel air starved bump the min up to 7.

Thanks Fred, I don't even notice any back pressure with this machine...maybe I have been doing this so long I dont realize it...

I'll bump to 6 tonight. Would you still recommend the EPR change at the same time even though I don't notice any back pressure?

I attached the last 6-mos - doesn't it appear the Auto is the better setting for me?

[Osiris357]

The machine doesn’t adjust when you move. It responds to flow limitations, snores, and events if they occur within 2 mins of each other. 

As for the pressure keeping your nose clear. I doubt it. It’s the humidity that helps with that. Those turbinates will swell regardless of pressure. At least in my experience.

Edit:
Events have to happen within 2 minutes of each other. With flow limitations it increases immediately and with snores they have to have some volume to them. Gentle snoring will not get a response from the machine. It will keep chugging along until a flow limitation or a couple of events